PHOTON Trial Outcomes: Impact on DME Patient Care in Clinical Practice

John Kitchens, MD, and Diana Do, MD, delve into the PHOTON trial results and their significance for treating patients with diabetic macular edema (DME) in clinical settings. They discuss the half-life of aflibercept in wet age-related macular degeneration and its implications for drug durability. They explore the potential for more frequent dosing of aflibercept for DME, with a focus on safety monitoring and the use of adjuvant steroids.

See the key takeaways below, and listen to the full podcast for all the clinical pearls.

Considering aflibercept half-life and higher molar dose in ophthalmology.

• Highlighting the variability in intraocular half-life of aflibercept, including factors such as patient characteristics and vitreous liquefaction that may have an impact.
• Discussing the concept of nonresponders, and whether frequent dosing may indicate a need for more frequent treatment rather than a lack of response to the drug.

Using aflibercept for DME, with focus on dosing and response variability.

• Discussing whether aflibercept 8 mg every 12-16 weeks is noninferior to 2 mg every 8 weeks in DME patients.
• Using the art of medicine to tailor aflibercept dosing based on patient response.

Using higher doses of aflibercept for DME, with potential for more frequent dosing.

• Mixing steroids with aflibercept may help treat recalcitrant DME.
• Using combination therapy shows improved response in DME treatment.
• Discussing safety signals for hypertension, intraocular inflammation, and retinal vasculitis for patients receiving aflibercept 8 mg.